The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.

guest post by Susan J. Noonan, M.D., M.P.H.

At this time of the year, many of us are surrounded by people and environments that are wrapped up in the joy and chaos of the holiday season. You can’t seem to go anywhere without seeing festive decorations and feeling the energy of others running around. If you are suffering from depression or bipolar depression, this can be a more stressful, burdensome, and irritating time than usual. When your mood and energy levels are down, it is often difficult to muster the effort to participate in the activities of the season, especially since you may have no interest in doing so. That is part of the illness. But at the same time you may feel pressure to participate, either from within or from family members. Pressure to put on a cheery disposition around others. Pressure to think of gift-giving ideas and then to actually go out and buy the items at a crowded shopping mall—a real challenge! Pressure to prepare an elaborate holiday meal for your family. Pressure to attend the many holiday functions at work or school or with friends or family members. You may also feel a false sense of competition with in-laws or neighbors to prepare the more celebratory holiday experience. In addition, you may carry around a set of expectations for what you “should” do at this time of year and berate yourself for not following through.

Expectations are tricky. At the holiday time, they often appear as an artificial set of standards that you impose upon yourself, based upon some unreachable ideal in a magazine, on television, or that your great-grandmother was said to have embodied. Trying to reach these unrealistic expectations will only bring you disappointment and more stress, not pleasure. Instead, think about where you are with your depression, and what you can realistically do now for yourself and your family. Set out small goals for your holiday season, ones that are attainable. Break each one down into small steps. Keep it all very simple, and you and others will enjoy the holidays more. Remember to remove the word “should” from your vocabulary—it often gets you into trouble. Instead of saying “I should” do this or that, replace it with “I would like” to do this or that. And then, if possible, aim for your more realistic goal and don’t be upset if you cannot reach it today.

Expectations from family members are also difficult. They often have history associated with them, based on years past or long-held family traditions. Just because these demands and routines existed in the past does not mean that you have to be held to them this particular year. Again, consider where you are now with your depression, what you can do realistically at this moment, and hold yourself to that. Say “no” at times if you need to. Explain your present situation, and your loved ones will understand.

You can get through the stress of the holiday season by following the basics of mental health to take care of yourself and by using sound coping skills, all of which I describe in my book Managing Your Depression: What You Can Do To Feel Better. Make sure that you keep up with a regular sleep pattern, follow a healthy diet instead of relying on heavy holiday buffets, hold alcohol to a minimum, and get daily exercise. Keep up with your daily routine and structure, maintain healthy social contacts, and avoid isolation. Use effective coping skills to manage the additional stressors of the season. Stay well!